We found there were measures in place that supported people to avoid the risk of their health and welfare deteriorating whilst they used the service. For most people the planning process for discharge started as soon as the person started using the service. This supported people to move back to their local communities.

However, for some people the care planning focussed on managing current need rather than assessing and planning proactively to improve the life experiences for people. We found that the majority of staff lacked understanding of the recommended clinical and psychological approaches to assessing and planning for people who display behaviour that can challenge, such as active support, positive behaviour support and behaviour analysis. These approaches help staff understand the reasons for people’s behaviour and support person centred care planning.

However, overall we found care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare.

We found people who use the service were protected from the risk of abuse, because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening. The provider responded appropriately to any allegation of abuse.

People who use the service were protected against the risk of unlawful or excessive control or restraint because the provider had made suitable arrangements.

People we spoke to were very positive about the care they received and very complimentary about their relationships with the staff.

Individuals had access to a wide range of therapies and activities both on and off the unit and the care that was provided was personalised in meeting the needs of individuals

One person we spoke to at the time of the visit said he was very happy with the care he received and the care staff were "nice"

We observed care practice on the visit and we found the atmosphere within the units to be calm and organised. Staff were attending to peoples needs in an appropriate manner, and there was good interaction between the staff and the people who use the service.

From the information from interviews with parents and staff it was clear that there were many safeguards in place to keep patients’ needs met, so they were less likely to exhibit challenging behaviour.

One patient told us that staff were “alright” and that they had never hurt her.

Patients were invited to attend their care planning meetings and were able to make decisions about their care. They were supported to take part in an appropriate range of activities.

One patient told us that she always attended her care planning meetings and that she had a monthly meeting with a psychologist, which she found helpful. She explained that she had a “job” delivering post around Bankfields Court for which she received a small weekly wage. She liked to go out shopping and staff took her on holiday once a year. She had regular telephone contact with her elderly mother and was planning to visit her soon.